NPIMap

Organization Active NPI

Caritas Residence

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Aquebogue, NY
National Provider Identifier
1396863460
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
6186447 Issued in NY
Legal business name
CARITAS RESIDENCE
Practice address
4 Hilton Court
Aquebogue, NY 11931-2383
Phone
(631) 665-3434
NPI assigned
Mar 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edwin M Kennedy
Title
Cfo
Phone
(516) 733-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 6186447 NY Primary

Addresses

Primary practice location

4 Hilton Court
Aquebogue, NY 11931-2383

Mailing address

PO Box 2383
Aquebogue, NY 11931-2383
Phone (631) 665-3434

Other identifiers 1

IdentifierTypeStateIssuer
02245930MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities of the Diocese of Rockville Centre26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396863460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2383",
            "city": "AQUEBOGUE",
            "state": "NY",
            "postal_code": "119312383",
            "telephone_number": "631-665-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HILTON COURT",
            "city": "AQUEBOGUE",
            "state": "NY",
            "postal_code": "119312383",
            "telephone_number": "631-665-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARITAS RESIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "516-733-7000"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NY",
            "license": "6186447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02245930",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aquebogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.